Treatment Methods Research Articles

The Effect of Autologous Platelet Rich Plasma on Endometrial Receptivity: A Narrative Review.

Background and Objectives: Autologous platelet-rich plasma (PRP) transfusions are a relatively new treatment method used in different fields of medicine, including the field of reproductive medicine. One of the applications of these concentrated platelet infusions is the treatment of endometrial receptivity, which is a key factor for embryo implantation. There are implications that PRP infusions can lead to increased endometrial thickness, endometrial receptivity, and significantly elevated clinical pregnancy rates. Our objective is to briefly understand what PRP is and to, through a narrative review, summarize the findings from studies focused on evaluating the benefits of PRP infusions to treat thin endometrium with the goal of achieving better endometrial receptivity. Materials and Methods: Reference data was searched using Medline, PubMed, and EMBASE to identify reports from 2015 to 2024. The combination of search words used was "PRP" and "platelet-rich plasma" with "thin endometrium", "endometrial receptivity", "endometrial thickness", and "endometrial implantation". Obtained articles were screened, and suited studies (randomized controlled trials, case reports, case series, pilot studies, and reviews) were included in the present review. Reports not available in the English language were eliminated from the current review. Results: The results from most of the reviewed studies showed a positive effect of autologous PRP infusions on increasing endometrial thickness, enhancing endometrial receptivity, and elevating clinical pregnancy rates. The majority of the evaluated findings revealed endometrial thickness > 7 mm (increased endometrial thickness was observed in each evaluated study) following the PRP treatment. More than 50% of the evaluated studies resulted in enhanced endometrial thickness, increased endometrial receptivity, and an elevated pregnancy rate after the PRP application. Conclusions: Autologous PRP infusions for treating endometrium are a relatively new method that has shown promising results. Its major strengths are availability and proper application, which eliminates possible immunological reactions or disease transmission. The main drawbacks are not enough data on safety (i.e., its effect on endometriosis) and the lack of uniformity in the PRP preparation, which would provide optimal standardized quality and quantity of the PRP product and, thus, optimal treatment results.

Comparison of clinical efficacy of different internal fixation methods in older adult patients with osteoporotic fractures of proximal humerus

ObjectiveTo compare the efficacy of three treatment methods for older adult patients with osteoporotic proximal humerus fractures: proximal humerus locking plate (PHILOS) combined with calcium sulfate injection, PHILOS plate alone, and artificial hemi-shoulder joint replacement.MethodsThe clinical data of 48 older adult patients with osteoporotic proximal humerus fractures admitted to the Shoulder and Elbow Surgery Department of Zhongshan Hospital Affiliated with Dalian University from February 2018–August 2021 were retrospectively analyzed. The patients comprised 18 males and 30 females, with a mean age of (68.6 ± 5.8) years. The 48 patients were divided into three groups based on their treatment methods: Group A: 16 patients treated with PHILOS plate combined with calcium sulfate injection. Group B: 16 patients treated with the PHILOS plate alone. Group C: 16 patients treated with artificial hemi-shoulder joint replacement. Key parameters such as operation time, blood loss, incision length, operation cost, and shoulder joint motion at the final follow-up were recorded and compared. Shoulder joint function was evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS) for pain, University of California Shoulder Joint Score (UCLA), and Brief Shoulder Function Test (SST).ResultsThere were no statistically significant differences in the preoperative general data between the three groups (P > 0.05), indicating comparability. There was no significant difference in operation time, blood loss, and incision length among Groups A, B, and C (P > 0.05). However, Group C had significantly higher operation costs compared to the other two groups (P < 0.05). At the final follow-up, there were no significant differences in shoulder flexion and rotation among the three groups (P > 0.05). However, a statistically significant difference in abduction was observed between Group A and Group C (P < 0.05). No significant differences were found in ASES, VAS, UCLA, and SST scores among the three groups at the last follow-up (P > 0.05).Complications occurred in 1 patient (Group A), 3 patients (Group B), and 4 patients (Group C), showing a statistically significant difference among the groups (P < 0.05).ConclusionAll three surgical methods are effective in treating older adult osteoporotic proximal humerus fractures, as they significantly alleviate pain and restore joint function. However, the use of a PHILOS plate combined with calcium sulfate injection (Group A) is particularly effective, demonstrating reliable clinical efficacy with fewer complications.

Magnetic beads as intravesical foreign bodies in children: our clinical experience

PurposeTo analyze the clinical data of five patients involving intravesical magnetic beads, summarizing diagnostic and therapeutic experiences.MethodsFrom January 2018 to November 2023, five pediatric patients were treated for intravesical magnetic beads at Shenzhen Children's Hospital. We retrospectively reviewed and analyzed the records of these patients, including demographic characteristics, clinical symptoms, imaging studies, and treatment methods.ResultsAll intravesical magnetic beads were retrieved from patients’ bladders. The patients ranged from 12 to 14 years, with a mean age of 13 years. None of them had a history of psychiatric disorders. Depending on the number of magnetic beads, their aggregation state, and the time since insertion, Three cases were successfully retrieved via cystoscopy, one via pneumovesicoscopy, and another via open surgery. No complications were observed during the postoperative follow-up.ConclusionMagnetic beads are a relatively rare type of intravesical foreign bodies and should be surgically removed as soon as possible. Cystoscopy is the first method for both diagnosis and treatment. When magnetic beads cannot be retrieved via cystoscopy, pneumovesicoscopy may be a viable option for the retrieval of foreign bodies. When endoscopic techniques are unsuitable or have failed, open surgery is a necessary option.

Epoetin alpha in multiple myeloma: literature review and our own experience

Background. Anemia is the main symptom of multiple myeloma (MM) both at the time of disease onset and during tumor progression. Previously, the main method of anemia treatment was blood transfusion therapy. Currently, blood transfusions are supplemented by erythropoietin (EPO) administration. Safety and effectiveness of the drug have been proven in multiple trials including trials involving oncohematological patients.Aim. To present the results of using epoetin alpha (Eralfon) in patients with MM complicated by dialysis-dependent myeloma cast nephropathy in real clinical practice; to analyze the literature data on the use of EPO for the treatment of anemia in MM patients.Materials and methods. A retrospective analysis of a series of clinical observations was carried out: 4 patients with newly diagnosed MM at the ages between 52 and 60 years who underwent treatment at the Department of Hematology and Chemotherapy of Paraproteinemic Hemablastoses with a Bone Marrow and Hematopoietic Stem Cell Transplantation Block. All patients were diagnosed with myeloma cast nephropathy with significantly decreased glomerular filtration rate of 7–15 mL/min requiring renal replacement therapy. At the time of disease diagnosis, median hemoglobin level was 75 g/L, median creatinine level was 517.5 µmole/L. Endogenous EPO level was measured in all patients prior to epoetin alpha prescription: it varied between 2.31 and 149.6 IU/mL. Epoetin alpha (Eralfon) was prescribed at dose 12 000 IU – 0.3 mL subcutaneously 3 times a week. A review of the literature data on the use of EPO in patients with MM was conducted.Results. All patients at MM onset were dependent on renal replacement therapy and blood transfusion, therefore epoetin alpha was prescribed immediately. In case of renal function recovery and end of dialysis at target hemoglobin levels, administration of the drug was ceased. If dependence on renal replacement therapy persisted, epoetin alpha treatment continued as synthetic function of EPO-producing cells was compromised. In all clinical cases, epoetin alpha therapy was effective.Conclusion. Clot formation prevention should be kept in mind during epoetin alpha therapy. Decreased requirement for blood transfusions, improved quality of life with favorable safety profile of the drug make epoetin alpha an indispensable part of accompanying therapy in patients with MM and anemia.

Interpretable Deep Learning for Pneumonia Detection Using Chest X-Ray Images

Pneumonia remains a global health issue, creating the need for accurate detection methods for effective treatment. Deep learning models like ResNet50 show promise in detecting pneumonia from chest X-rays; however, their black-box nature limits the transparency, which fails to meet that needed for clinical trust. This study aims to improve model interpretability by comparing four interpretability techniques, which are Layer-wise Relevance Propagation (LRP), Adversarial Training, Class Activation Maps (CAMs), and the Spatial Attention Mechanism, and determining which fits best the model, enhancing its transparency with minimal impact on its performance. Each technique was evaluated for its impact on the accuracy, sensitivity, specificity, AUC-ROC, Mean Relevance Score (MRS), and a calculated trade-off score that balances interpretability and performance. The results indicate that LRP was the most effective in enhancing interpretability, achieving high scores across all metrics without sacrificing diagnostic accuracy. The model achieved 0.91 accuracy and 0.85 interpretability (MRS), demonstrating its potential for clinical integration. In contrast, Adversarial Training, CAMs, and the Spatial Attention Mechanism showed trade-offs between interpretability and performance, each highlighting unique image features but with some impact on specificity and accuracy.

Metabolome modification and underlying biomarker of noise-induced hearing loss Guinea pig cochlear fluid

Background Noise-induced hearing loss (NIHL) is a kind of acquired sensorineural hearing loss and has shown an increasing incidence in recent years. Hence, elucidating the exact pathophysiological mechanisms and proposing effective treatment and prevention methods become the top priority. Though a great number of researches have been carried out on NIHL, few of them were focused on metabolites. Aims/Objectives To reveal the metabolomic changes in cochlear fluid after noise injury and search for underlying inner ear biomarkers of NIHL. Material and methods In this study, cochlea fluid extracted from guinea pigs after impulse noise exposure were subjected to GC-MS and LC-MS untargeted metabolomics analysis. Results After impulse noise exposure, 62 significantly changed metabolites in guinea pig cochlea fluid were screened out and deoxyribose 1-phosphate was selected as the key metabolite and underlying biomarker for NIHL. KEGG pathway analysis showed that oxidative phosphorylation, glycerophospholipid metabolism, pyrimidine metabolism and pentose phosphate pathway were significantly changed at all observed time points after noise. Conclusions and significance This study effectively promoted the application of metabolomics in hearing research. The pathophysiology process of NIHL in the inner ear was closely connected with oxidative phosphorylation, glycerophospholipid metabolism, pyrimidine metabolism and pentose phosphate pathway and deoxyribose 1-phosphate could be the biomarker for NIHL.

Cell therapy for scleroderma: progress in mesenchymal stem cells and CAR-T treatment

Cell therapy is an emerging strategy for precision treatment of scleroderma. This review systematically summarizes the research progress of mesenchymal stem cell (MSC) and chimeric antigen receptor T cell (CAR-T) therapies in scleroderma and discusses the challenges and future directions for development. MSCs possess multiple functions, including immunomodulation, anti-fibrosis, and promotion of vascular regeneration, all of which can improve multiple pathological processes associated with scleroderma. Studies have demonstrated that MSCs can alleviate skin fibrosis by inhibiting CCL2 production and reducing the recruitment of pathological macrophages; their paracrine effects can exert extensive regulatory functions. CAR-T cell therapy ca specifically target and eliminate autoreactive immune cells, exhibiting enhanced specificity and personalized potential. Different cell therapies may have complementary and synergistic effects in treating scleroderma, such as MSCs exerting their effects through paracrine mechanisms while CAR-T cells specifically eliminate pathological cells. Furthermore, cell-free therapies derived from MSCs, such as extracellular vesicles or exosomes, may help circumvent the limitations of MSC therapy. Although cell therapy has opened new avenues for the precision treatment of scleroderma, it still faces numerous challenges. In the future, it is essential to strengthen integration of basic and clinical research, establish standardized protocols for cell preparation and quality control, develop personalized treatment plans, and rationally combine cell therapy with existing treatment methods to maximize its advantages and improve patient prognosis and quality of life.

Accompanying immunotherapy and quality of life in patients with locally advanced non-small cell lung cancer who received simultaneous chemoradiotherapy

Background. Lung cancer continues to be in the leading positions in mortality among all malignant neoplasms; 85 % of all cases are nonsmall cell lung cancer (NSCLC), and in 40 % of patients the process is diagnosed at a common unresectable stage. Chemoradiotherapy is the standard of treatment for this category of patients, which allows to improve the results of local control and overall survival. In Russia, chemoradiotherapy accounts for about 4 % of all treatment methods. Perhaps this is due to high toxicity of this method and, as a result, a deterioration in quality of life of patients.Aim. To assess the quality of life of patients with locally advanced NSCLC during simultaneous chemoradiotherapy in combination with and without accompanying immunotherapy.Materials and methods. The study included 60 patients with locally advanced NSCLC. The study group (n = 30) received a radical course of simultaneous chemoradiotherapy with the use of accompanying immunotherapy with azoximer bromide. Patients in the control group (n = 30) underwent a course of simultaneous chemoradiotherapy in the standard mode. We evaluated the criteria of quality of life in patients using questionnaires EORTC QLQ-LC13, EQ-5D-5L, EORTC QLQ-C30.Results. In the study group, an improvement in most of the parameters of quality of life and a decrease in the severity of symptoms were demonstrated compared with the control group.Conclusion. The study demonstrated a tendency to reduce hematological toxicity and improve the quality of life of patients with NSCLC. This allows us to consider the possibility of using accompanying immunotherapy in combination with chemoradiotherapy as an additional therapeutic option that improves the quality of life of patients and the tolerability of the treatment.

Recent Advances of Using Polymer Nanocomposites For the Removal of Heavy Metal Ions From Waste Water: A Review

A major factor in the development of modern environmental engineering is the necessity of treating water pollutants. The effective removal of metallic ions of wastewater systems, using adsorption techniques, different adsorbents have been widely utilized; among these adsorbents, polymer-based composites have garnered a lot of interest due to their characteristics of environmental harmlessness and degradability. By combining the best features of both polymer and nanocomposites can offer improved chemical, physical, mechanical, and compatibility over single polymers. The review underscores the importance of polymer-based nanocomposites in offering inventive wastewater treatment methods. A thorough examination of current research and obstacles in the field of developing nanotechnology highlights these materials' ability to address the intricate problem of heavy metal ion contamination. The removal of heavy metal ions from various wastewater sources can be accomplished sustainably and effectively by integrating nanocomposites, with an emphasis on their design and manufacture. The investigation of new advances in polymer nanocomposites for the removal of heavy metal ions lays the groundwork for further study and creativity in this crucial area of environmental engineering. Using the adaptability of polymers and the special qualities of nanomaterials, this strategy develops cutting-edge solutions to deal with the intricate problems brought on by heavy metal ion pollution. Through a focus on accuracy in the design and manufacturing of these nanocomposites, scientists and industry professionals can create materials that are specialised, effective, and can make a substantial contribution to the development of wastewater treatment systems. The purpose of this research is recent analyses and challenges in the field of nanotechnology development. The data presented in this analysis will be helpful for future efforts to design and produce polymer-based Nanocomposites for the removal of a wide range of heavy metal ions

Research Progress of Traditional Chinese Medicine in The Treatment of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease mainly characterized by joint synovitis, with complex etiology and pathogenesis, intractability and high disability, which affects patients' quality of life, physical and mental health seriously. With the in-depth research of traditional Chinese medicine (TCM) in the field of RA, Chinese medicine treats RA by etiology and pathogenesis analysis, syndrome differentiation, adopting internal treatment, external treatment, and combining internal and external treatments, the curative effect is remarkable. TCM treatment has unique advantages in effectively alleviating pain symptoms, slowing down the process of disease development and reducing adverse reactions efficiently. Based on the literature research, this article will review and summarize the etiology and pathogenesis of RA, Chinese medicine treatment methods, and modern research progress, as well as analyze the advantages and challenges of Chinese medicine in the treatment of RA, so as to provide reference value for the diagnosis and treatment of RA and contribute to new research directions and new drug development.

Efficacy of Renuvion Helium Plasma to Improve the Appearance of Loose Skin in Patients Undergoing Abdominoplasty After Massive Weight Loss: A Prospective Controlled Randomized Study.

Renuvion was the first FDA approved helium plasma device utilized for subdermal tissue heating to reduce skin laxity. The purpose of this study was to demonstrate that the use of Renuvion improves the outcomes, skin quality and reduces the edema faster after lipoabdominoplasty. Patients with abdominal skin laxity after a weight loss of at least 20kg, nonsmokers, without major comorbidities, with a minimum 2-year follow-up and standardized pre- and postoperative photographs were included in this study. They were randomly divided in two groups: group 1, lipoabdominoplasty alone; group 2, lipoabdominoplasty and Renuvion. Both the patients and two of the authors measuring outcomes were blinded to the treatment methods. Postoperatively, all patients were administered the BODY-Q satisfaction with abdomen and appraisal of excess skin scales. Two independent plastic surgeons reviewed photographs, rating the outcomes on a 1-5 visual analog scale (VAS). Pinch test and ultrasound of the subcutaneous tissue were also performed. Seventy-six patients were enrolled, 33 males and 43 females, aged between 20 and 50 years. The BODY-Q satisfaction with abdomen scores were higher in group 2 in the 6-month (p=0.007), 1-year (p=0.021) and 2-year (p=0.024) evaluations. The BODY-Q appraisal of excess skin scores were significantly higher in group 2 in the 6-month (p<0.0001), 1-year (p<0.0001) and 2-year (p<0.0001) postoperative evaluations. The VAS scale reported higher scores in group 2 (p=0.01). Ultrasound at 6 months postoperatively demonstrated lower subcutaneous thickness in group 2 (31mm±2.8SD) compared to group 1 (42mm±1.4SD) implying a faster edema reabsorption. Data showed a significantly greater improvement of abdominal skin laxity in patients treated with Renuvion compared to those who underwent lipoabdominoplasty alone. This is the first prospective randomized study about Renuvion and lipoabdominoplasty and could be considered a pilot study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Multidisciplinary Approach in the Treatment of Gastric and Duodenal ulcer Complicated by Bleeding

A multidisciplinary team is a team of specialists from different fields of medicine, united by the solution of one problem on previously agreed principles. A possible example of this approach in the treatment of gastric ulcer and duodenal ulcer complicated by bleeding is the joint interaction of doctors - general surgeons, endoscopists, gastroenterologists, general practitioners, therapists, nutritionists, psychologists. Since these specialists often encounter these dangerous diseases, a joint approach to their treatment is fully justified. When considering many medical problems, cooperation and joint work of several at once is necessary, both narrow specialists and general practitioners who work in the same team and try to achieve a common goal. In modern world medical practice, this approach is used more and more, because it allows you to combine the knowledge of different doctors, for the benefit of the patient and make the treatment closer to this patient. Today, a multidisciplinary approach of a team of doctors of different specialties is increasingly engaged in the treatment of patients in the world's leading clinics. It is believed that this approach has a future, because it allows to easily and quickly determine the sequence and priority of treatment methods. Also, recommendations to the patient are given in agreement and situations where one contradicts the other are excluded. Collegiality is observed.

Total joint arthroplasty of the thumb CMC joint.

Rhizarthrosis-osteoarthritis of the thumb carpometacarpal (CMC) joint is usually a primary idiopathic disease. Total joint arthroplasty (TJA) is one of the surgical treatment options for symptomatic advanced thumb CMC arthritis. This retrospective study aims to evaluate the mid-term functional and radiological results of TJA with the minimum follow-up period of 3 years after the surgery. Presented are the results of 136 total trapeziometacarpal joint replacements in the group of 105 patients consisted of 96 women and 9 men. Used prostheses were ELiS® implant (27 cases), Ivory® implant (42 cases), Touch® Dual mobility (67 cases). The follow-up period was minimally 3 years postoperatively. In all the patients, along with range of motion and radiologic evaluation of implant position, the function and pain of operated joint were evaluated using DASH and VAS score at regular intervals pre- and postoperatively. At a mean of 85months (range 38-126months) post-operatively, patients in 116 cases (85%) reported full satisfaction and absence of symptoms and difficulties. In 12 cases (9%) some slight residual post-exercise pain was reported. In eight cases (6%) patients suffered from episodic rest-pain, but with a lower intensity than in the preoperative period. Postoperatively, the patients declared subjective improvement in hand function. The total DASH score and VAS score decreased in all patients, while ROM increased. The course of all of TJA surgeries was complication-free. Five patients needed revision surgery. In two patients a dislocation has occurred and in three cases a loosening of the cup's implant was reported. The most frequent postoperative complication was the occurrence of transient paraesthesias of the thumb in eight cases (6%). TJA is the method of choice in management of advanced symptomatic osteoarthritis of the thumb CMC joint. Mastering surgical technique, TJA represents safe and effective treatment method in advanced degenerative changes of the thumb CMC joint and it's benefits exceed possible perioperative and postoperative risks.

Biorefinery—inspired, two-step valorization strategy to manage plant-based recalcitrant organic waste, involving solvent extraction, and fermentation with Bacillus clausii—a proof of concept study

Approximately 40–50% of municipal solid waste is organic and causing biogenic malodor and infections, due to inefficient treatment methods. Biorefinery-based bioremediation and valorization is in vogue against these conventional strategies since it combines unit operations for better efficiency and productivity. Deriving inspiration, the proposed strategy puts together a unique and compatible combination of processes. This novel two-step valorization workflow involves the extraction of small molecules using organic solvents, and fermentation of resulting denatured residues (increased biodegradability or decreased recalcitrance) of reduced microbial load. The extraction step also doubles up as a sterilization event, with different solvents (petroleum ether, chloroform, ethyl methyl ketone and methanol) exhibiting varied efficiency, methanol and ethyl methyl ketone being the most effective. Different recalcitrant plant organic wastes resulting from four plants (Cocos nucifera, Allium cepa, Artocarpus hirsutus and Swietenia mahagoni) were used as feedstocks in the preliminary exploratory study using chosen pathogenic bacteria. Onion peel (Allium cepa) ethyl methyl ketone extract was chosen for further studies, as it inhibits Salmonella enterica, which is associated with infection and malodour (due to biogenic H2S) in wastewater. Further, fractionation of the extract yielded quercetin and its glycoside. The onion peel residue, after solvent extraction was fortified with peptone and essential minerals to promote the growth of Bacillus clausii. Fortified post-extraction residue supported the growth better than the pre-extraction residue. The residue resultant after solvent extraction was fermented with Bacillus clausii and with release of bioactive supernatants. The concentrated supernatant showed significant inhibition of Salmonella enterica and Shigella dysenteriae. Additionally, all the exudates showed considerable inhibition in H2S production, respectively.

An Efficient 3D Convolutional Neural Network for Dose Prediction in Cancer Radiotherapy from CT Images.

Introduction: Cancer is a highly lethal disease with a significantly high mortality rate. One of the most commonly used methods for treatment is radiation therapy. However, cancer treatment using radiotherapy is a time-consuming process that requires significant manual work from planners and doctors. In radiation therapy treatment planning, determining the dose distribution for each of the regions of the patient's body is one of the most difficult and important tasks. Nowadays, artificial intelligence has shown promising results in improving the quality of disease treatment, particularly in cancer radiation therapy. Objectives: The main objective of this study is to build a high-performance deep learning model for predicting radiation therapy doses for cancer and to develop software to easily manipulate and use this model. Materials and Methods: In this paper, we propose a custom 3D convolutional neural network model with a U-Net-based architecture to automatically predict radiation doses during cancer radiation therapy from CT images. To ensure that the predicted doses do not have negative values, which are not valid for radiation doses, a rectified linear unit (ReLU) function is applied to the output to convert negative values to zero. Additionally, a proposed loss function based on a dose-volume histogram is used to train the model, ensuring that the predicted dose concentrations are highly meaningful in terms of radiation therapy. The model is developed using the OpenKBP challenge dataset, which consists of 200, 100, and 40 head and neck cancer patients for training, testing, and validation, respectively. Before the training phase, preprocessing and augmentation techniques, such as standardization, translation, and flipping, are applied to the training set. During the training phase, a cosine annealing scheduler is applied to update the learning rate. Results and Conclusions: Our model achieved strong performance, with a good DVH score (1.444 Gy) on the test dataset, compared to previous studies and state-of-the-art models. In addition, we developed software to display the dose maps predicted by the proposed model for each 2D slice in order to facilitate usage and observation. These results may help doctors in treating cancer with radiation therapy in terms of both time and effectiveness.

An Inquiry into the Health Principles and Their Uses Made by the Ancients for Social Compassion (Based on Rajarata Civilization)

Since ancient times, health has been given priority among humans. This research aims to identify the health policies made by the ancients during the Rajarata civilization period. The research problem here is how the developed health policies were used for social solidarity and what is their utility. The historical research method was used as the research method here. Sourced facts confirm that the ancient Sri Lankan people also thought of health as an absolute profit. If the health system is of high quality, it is an indication that society at that time acted with compassion. Traditional folk beliefs also prevailed among the people at this time. Accordingly, the ancients strongly believed that diseases are caused by angering the forces called Va-Pit-Sem and other beliefs. It is a mandatory factor to have medical facilities in a state in case of emergencies such as epidemics, pneumonia and war. Therefore, based on these factors, the ancients worked to support the government in making health policies and to raise the health sector. It is stated in the Mahavamsa that ancient medicine was concerned with medical services such as various methods of treatment, style medicine, psychological treatment etc. According to the Mahavamsa, King Dutugemunu has fondly remembered the medical facilities he provided for the public as one of the highest services he did at the time of his death. King Buddhadasa played a special role in the ancient medicine service. The king, who worked with great kindness and compassion to cure the sufferings of his people by performing the affairs of the state well, was a physical and mental doctor who understood it well. During the Polonnaruwa era, King Maha Parakramabahu showed special interest in improving the health of the country's inhabitants. In the continuous history of several centuries, the implementation of the state policies applied by the rulers of the Rajarata Civilization period also on health shows the nature of formal governance. It can also be recognized that Sri Lankan society is not only concerned with public health but also with compassion towards animals and implemented those health policies.

Mobile health in communication disorders: willingness to use, attitude, advantages, and challenges from the perspective of patients

IntroductionCommunication disorders are one of the most common disorders that, if not treated in childhood, can cause many social, educational, and psychological problems in adulthood. One of the technologies that can be helpful in these disorders is mobile health (m-Health) technology. This study aims to examine the attitude and willingness to use this technology and compare the advantages and challenges of this technology and face-to-face treatment from the perspective of patients.MethodsThis descriptive study was conducted with a researcher-made questionnaire and investigated the willingness and attitude of patients with communication disorders to use mobile health technology. The face and content validity of the questionnaire were examined with the help of experts in speech therapy, health information management, and medical informatics. Chi-square, Fisher's exact test, and the Kruskal–Wallis test were used to analyze the relationship between variables. Also, the challenges and advantages of mobile health technology and face-to-face treatment were extracted from the patient's answers and presented in the form of main themes and sub-themes.ResultsOne hundred seventy patients participated in this study. The results of this study showed that 57 (33.5%) participants preferred face-to-face visits, 11 (6.5%) preferred m-Health, and 102 (60.0%) preferred the combination of mobile applications and the face-to-face visits method. The results showed a statistically significant relationship between "Residence (rural or urban)", "Having trouble traveling to speech therapy centers", and "Delaying treatment due to lack of access to speech therapists" with treatment methods (face-to-face, mobile health, face to face and mobile health). Accessibility and convenience, treatment efficacy and variety, patient empowerment and confidence, family involvement and support, cost and time efficiency, treatment adherence and completion, and comfort and lifestyle compatibility were six categories related to the advantages of mobile health technology from the point of view of patients with communication disorders. Also, technological challenges, effectiveness and quality concerns, patient experience and engagement, and trust and confidence issues were mobile health challenges from the patients' point of view.ConclusionThe results of this study showed that patients tend to use both face-to-face interactions and mobile health. Integrating both m-Health and traditional methods can optimize speech therapy outcomes. Addressing challenges such as inadequate technological infrastructure and data security is crucial for successful implementation.

The Five-Year Outcomes of Breast Cancer Surgical Management at the Colentina Surgical Clinic, Bucharest, Romania: A Descriptive Retrospective Analysis Between 2019 and 2023.

Background: Breast cancer still represents the most commonly diagnosed cancer among women, accounting for 12.5% of all new annual cancer cases worldwide. In Romania in 2020, breast cancer was the most common, with a share of new cases of 26.9%, far behind the rates of colon cancer (11.8%) and cervix cancer (7.5%). The aim of this study is to reveal five years of experience in treating breast cancer at the Surgical Clinic of the Colentina Hospital in Bucharest, Romania. Methods: Retrospective analysis, including 68 patients admitted to our clinic between January 2019 and December 2023 undergoing modified radical mastectomy, sectorectomy, or subcutaneous mastectomy. Results: Madden-modified radical mastectomy with total excision of the axillary lymph nodes accounted for 77.94% of surgeries, with a complication rate of 13.2%, represented by lymphedema of the ipsilateral arm and prepectoral seroma. Conclusions: Continuous innovation regarding early diagnosis and treatment methods in our surgical clinic will, hopefully, contribute to improving the outcomes of our patients.

LncRNA NEAT1, an Important Biomarker Involved in the Pathological and Physiological Processes of Parkinson's Disease.

Parkinson's disease (PD) is a complex progressive neurodegenerative disorder and the pathogenesis and treatment methods are unknown. This aim is to investigate the effects of long non coding RNA NEAT1 (LncRNA NEAT1) on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD). Immunoprecipitation and western blot were used to search for the effects of LncRNA NEAT1 on PD. Tyrosine hydroxylase (TH) and brain derived neurotrophic factor (BDNF) were evaluated in substantia nigra (SN) region of the brain by immunohistochemical staining. Compared with the control group, the relative expression level of LncRNA NEAT1 in the MPTP group was significantly increased. LncRNA NEAT1 is negatively correlated with miR-376b-3p. LncRNA NEAT1 significantly increased oxidative stress, neuroinflammation along with enhanced neurotrophic potential via NLR family Pyrin domain protein 3 (NLRP3) pathway. In conclusion, these results indicated that LncRNA NEAT1 participated in the pathophysiological of PD and its mechanism via the miR-376b-3p/NLRP3 signaling pathway.

Unveiling Microscopic Variations during Photodynamic Therapy via Polarity-Responsive Fluorescence Lifetime Imaging.

Photodynamic therapy is a highly promising method for cancer adjuvant treatment. However, the current research on the microscopic changes during the photodynamic therapy process is still quite limited, which seriously impedes the deep understanding of the procedure. For this purpose, a novel polarity-responsive probe, MI-PPF, with excellent mitochondrial targeting and anchoring capabilities has been rationally designed and synthesized. Notably, MI-PPF has successfully realized the in situ detection of mitochondrial morphology and polarity alterations during the photodynamic therapy process in cancer cells through fluorescence lifetime imaging. The results showed that a series of phenomena such as deformation, shrinkage, vacuolation, and aggregation occurred in the mitochondrial morphology during photodynamic therapy. Concurrently, a decline in mitochondrial polarity is also noted, which may be closely linked to the mitochondrial oxidative stress response during this process. Furthermore, MI-PPF can be used for photodynamic therapy on tumor mouse models and has successfully achieved fluorescence lifetime imaging of tumor sections before and after photodynamic therapy, uncovering multifaceted changes in cell morphology, polarity, and polarity distribution within the mouse tumor model during the process. It is anticipated that this study will offer valuable insights and guidance to the research of mitochondrial-related fields and will boost the advancement of diagnostic and therapeutic areas for associated diseases.